噻唑烷二酮类药物对血压影响的荟萃分析。
A meta-analysis of the effect of thiazolidinediones on blood pressure.
作者信息
Qayyum Rehan, Adomaityte Jurga
机构信息
Prudich Medical Center, Montcalm, WV 24737, USA.
出版信息
J Clin Hypertens (Greenwich). 2006 Jan;8(1):19-28. doi: 10.1111/j.1524-6175.2005.04784.x.
In epidemiologic studies, insulin resistance is associated with hypertension. Thiazolidinediones (TZDs) are antidiabetic agents that decrease insulin resistance. Multiple clinical trials have evaluated the effect of TZDs on blood pressure (BP) with inconsistent results. The aim of this study was to estimate the effect of TZDs on BP. The authors searched PubMed for clinical trials published in English. A total of 37 clinical trials that reported a change in BP were included in the analysis. Trials with independent-group design and trials with pre-post design were evaluated separately. When compared with baseline, TZDs lowered systolic BP by 4.70 mm Hg (95% confidence interval, -6.13 to -3.27) and diastolic BP by 3.79 mm Hg (95% confidence interval, -5.82 to -1.77). When compared with placebo, TZDs lowered systolic BP by 3.47 mm Hg (95% confidence interval, -4.91 to -2.02) and diastolic BP by 1.84 mm Hg (95% confidence interval, -3.43 to -0.25). Thus, TZDs lower both systolic and diastolic BP, albeit the BP-lowering effect is small and may not be of clinical significance.
在流行病学研究中，胰岛素抵抗与高血压相关。噻唑烷二酮类药物（TZDs）是降低胰岛素抵抗的抗糖尿病药物。多项临床试验评估了TZDs对血压（BP）的影响，但结果不一致。本研究的目的是评估TZDs对血压的影响。作者在PubMed上检索了以英文发表的临床试验。共有37项报告了血压变化的临床试验纳入分析。独立组设计的试验和前后设计的试验分别进行评估。与基线相比，TZDs使收缩压降低4.70 mmHg（95%置信区间，-6.13至-3.27），舒张压降低3.79 mmHg（95%置信区间，-5.82至-1.77）。与安慰剂相比，TZDs使收缩压降低3.47 mmHg（95%置信区间，-4.91至-2.02），舒张压降低1.84 mmHg（95%置信区间，-3.43至-0.25）。因此，TZDs可降低收缩压和舒张压，尽管其降压效果较小，可能不具有临床意义。
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